革兰阴性杆菌超广谱β-内酰胺酶基因分型及耐药相关性研究  

Genotypes of Extended-spectrum β-Lactamases Producing by Gram-negative Bacilli and Relations with Antimicrobial Susceptibilities

作　　者：王忠永[1] 李响新[2] 吕美艳[1] 王赛芳[1] 周明明[1] 周铁丽[1] 

机构地区：[1]温州医学院附属第一医院实验诊断中心,浙江温州325000 [2]温州市第二人民医院检验科,浙江温州325035

出　　处：《中华医院感染学杂志》2010年第16期2361-2364,共4页Chinese Journal of Nosocomiology

摘　　要：目的了解温州地区产超广谱β-内酰胺酶(ESBLs)菌株的基因分布及其与耐药的相关性。方法对临床分离的常见革兰阴性杆菌(大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌、鲍氏不动杆菌)的产ESBLs菌株进行基因分型,并对其耐药相关性进行分析。结果温州地区产ESBLs大肠埃希菌以携带CTX-M-9中的CTX-M-14型基因为主,且大多合并携带TEM-1型广谱酶基因;肺炎克雷伯菌以CTX-M-14和多亚型的SHV型基因型为主,亦大多合并携带TEM-1型广谱酶基因;在阴沟肠杆菌和鲍氏不动杆菌中ESBLs基因携带变化较大,阴沟肠杆菌中主要携带CTX-M-14、SHV-56型ESBLs基因及TEM-1型广谱酶基因,另外发现主要有VEB-1型基因携带;鲍氏不动杆菌中主要以特异的TEM-128和PER-1型基因携带为主,不同ESBLs基因携带菌株显示了较大的临床耐药差异。结论温州地区的革兰阴性杆菌存在ESBLs基因的多样性分布特征,不同的基因型ESBLs可能与介导不同的β-内酰胺类抗菌药物耐药相关。OBJECTIVE To investigate the distribution of the genotypes of extended-spectrum β-lactamases（ESBLs） producing by Gram-negative bacilli and their relations with antimicrobial susceptibilities.METHODS The clinical isolates of commonly encountered Gram-negative bacteria （Escherichia coli,Klebsiella pneumoniae,Enterobacter cloacae,and Acinetobacter baumannii） were confirmed by means of phenotypic confirmatory tests as recommended by the CLSI or by three-dimensional test.RESULTS The strains of ESBLs producing E.coli mainly carried CTX-M-14 type gene and most of them carried also TEM-1 type gene.K.pneumoniae mainly carryied CTX-M-14 type gene and multiple subtypes of SHV gene,the most of then also carried TEM-1 type gene.E.cloacae mainly carryied CTX-M-14,SHV-56,TEM-1 and VEB-1 type genes.While A.baumannii mainly specifically carried TEM-128 and PER-1 type genes in Wenzhou.CONCLUSION The ESBLs genotypes exist the various distribution characteristics of Gram-negative bacilli.The various genotypes of ESBLs may be related with the resistance to β-lactam antibiotics.

关 键 词：超广谱Β-内酰胺酶 革兰阴性杆菌 基因型 

分 类 号：R378[医药卫生—病原生物学]